Mental health problems after miscarriage continue after healthy birth

Embargoed until 03 March 2011

Women who experience depression and anxiety
after a miscarriage continue to experience these symptoms even if
they subsequently go on to have a healthy child.

The study, published online by the British
Journal of Psychiatry, found no evidence that mental health
problems associated with miscarriage or stillbirth end with the
birth of a healthy baby. Instead, women may continue to experience
symptoms for several years after the postnatal period.

The researchers studied 13,133 pregnant women
who were taking part in a long-term study known as the Avon
Longitudinal Study of Parents and Children (ALSPAC). The women were
asked to report the number of previous miscarriages and stillbirths
they had experienced. They were assessed for symptoms of depression
and anxiety twice during their pregnancy (at 18 and 32 weeks
gestation), and four times after giving birth (at 8 weeks, 8
months, 21 months and 33 months).

The majority of women (10,310) reported no
miscarriages. 2823 women (21%) reported having one or more previous
miscarriages. 108 (0.5%) reported having one previous stillbirth
and just 3 women had 2 previous stillbirths.

The researchers found that women who had lost
a baby in the past experienced significantly higher levels of
anxiety and depression during pregnancy – and this continued nearly
three years after they gave birth to a healthy baby.

Lead researcher Dr Emma Robertson Blackmore,
of the University of Rochester Medical Center in the USA, said:
“Our study clearly shows that the birth of a healthy baby does not
resolve the mental health problems that many women experience after
a miscarriage or stillbirth. This finding is important because,
when assessing if a women is at risk of antenatal or postnatal
depression, previous pregnancy loss is usually not taken into
account in the same way as other risk factors such as a family
history of depression, stressful life events or a lack of social
support.

“We know that maternal depression can have
adverse impacts on children and families. If we offer targeted
support during pregnancy to women who have previously lost a baby,
we may be able to improve health outcomes for both the women and
their children.”

Professor Jean Golding, founder of the ALSPAC
project, said: “This study is important to the families of women
who have lost a baby, since it is so often assumed that they get
over the event quickly, yet as shown here, many do not. This has
implications for the medical profession as well as the woman and
her family.”

Pregnancy loss associated with miscarriage or
stillbirth is common, affecting between 70,000 and 90,000 women in
the UK each year. 14-20% of pregnancies end in miscarriage (the
loss of pregnancy before 24 weeks), and stillbirth (the loss of a
pregnancy after 24 weeks) occurs in around 0.5% of pregnancies.
Between 50 and 80% of women who experience pregnancy loss become
pregnant again.